During a first interview with a client, a therapist will carefully question the client about their state of health to ascertain whether any contraindications exist. If the client is under the care of a doctor then the therapist may have to consult with them before beginning with any massage therapy.

Some of the major contraindications are:
Abnormal body temperature: If the client has a high temperature or fever (over around 37.5C) then massage is not recommended. Generally a fever indicates that the body is trying to isolate and eliminate an invading organism. The body steps up it's own defence mechanism in order to confine and eliminate the problem. Massage may tend to work against this.

Acute infectious disease : Any client with an infectious disease such as influenza, severe colds, typhoid and so on, should not be massaged. By receiving a massage, a client who is coming down with an acute viral infection will have the illness intensified (whilst exposing the massage therapist to the virus).

Inflammation :This is a common situation that we see. When there is acute inflammation, massage to that area is not advisable as it may further irritate the area and/or intensify the inflammation.
If you've had a recent injury (within the previous 24 hours) eg an ankle sprain or you've 'felt something go' in your back, then standard RICE First Aid principles apply.

Rest
Ice
Compression
Elevation

and consult your doctor or health care professional. Massage to the inflammed area at this time may cause more harm than good.
(nb apply ice for only about 15 minutes at a time - a commercial ice pack or simply crushed ice wrapped in a towel is effective. Do not apply directly onto the skin or leave for extended periods)

Although working directly on an area may be contraindicated, working around the area to release muscle restrictions and/or trigger points may be beneficial in promoting the natural healing properties of the body. Also once the inflammation has subsided (typically around 72-96 hours after the injury) then massage can assist in improving joint mobility and reducing scar tissue formation.

Varicose veins: With varicose veins, the valves of the veins break down normally because of back pressure in the circulatory system and the veins bulge. This generally occurs in the legs as a result of gravity, the result of crossing of the legs or other sitting postures that inhibit circulation to and from the legs. Standing for long periods of time can also be a contributing factor. During pregnancy, pressure on the veins in the pelvic area can influence the formation of varicose veins.
Any deep massage on and around the area of varicose veins may set a blood clot loose in the general blood circulation and as such, massage is contraindicated.

Osteoporosis: In the advanced stages of osteoporosis, bones can become brittle, occasionally reaching the point that they can be easily broken. Before commencing a massage therapy program, a client with osteoporosis should obtain the advice of their health care practitioner.

High Blood Pressure : If a client has a history of high blood pressure, then their health care practitioner should be consulted prior to massage. It is possible that massage may be of assistance in relieving some hypertension associated with high blood pressure. Low blood pressure is not a major consideration in massage (although care must be taken at the end of the massage - in some cases clients can experience dizziness with a further drop in blood pressure).

Other contraindications: There are other numerous contraindications for receiving a massage. Generally the guidelines are straightforward - the massage therapist does not want to make any underlying medical condition worse and you don't want to pass anything contagious to your therapist.If you are unsure then please check with your doctor before commencing massage therapy.

The other conditions include:

• Systemic infections
• Fracture, bleeding, burns
• Cancer (without medical release)
• Open skin lesions or sores
• Blood clots